Inventing Diagnoses Rather Than Necessary Drugs

Growing up, I can’t recall any TV advertising for drugs unless, of course, you consider Bayer aspirin a pharmaceutical. Now I can’t escape them, especially during the evening news and 60 Minutes. Seems the FDA loosened the requirements in or around 1996, and Big Pharma has responded, now spending by some measures as much as $19 for advertising for every $1 for basic research. And this is just the tip-of-the-iceberg showing how they’ve switched from juggernauts of important research to re-jiggerers of old patents and remarketers of old or unnecessary or ineffective drugs. (See Dr. Ben Goldacre’s book Big Pharma, How Drug Companies Mislead Doctors and Harm Patients.) With Big Pharma generating an almost surround-sound level of breathless advertising to us (Direct-to-Consumer; DTC in FDA parlance), I keep wondering “What are they thinking?”

Is it that, despite all their marketing to doctors, including freebies, junkets, giveaways, meals, etc. they think doctors don’t know anything about drugs like Lipitor. As a result, we, the patients, need to be educated. Then, as they suggest, we “ask our doctor about it.” Then the doctor says: “Holy shit! There’s a drug that reduces cholesterol? Thanks for telling me. Let’s get you on it ASAP!”

Or is that they want to increase the pressure on doctors to prescribe drugs that they already know about, but have decided aren’t quite right for us. Maybe the doctor thinks that exercise or diet or some other lifestyle change should be encouraged before subjecting their patient to a chemical with known (and probably unknown) side effects? Or perhaps the doctor assesses us as borderline for it? Or maybe the doctor has independent knowledge (like from reliable scientific sources other than the company selling the drug) that it may not be as effective as claimed, as fully studied as the physician would like, as free of material side effects as the warning label states? Or maybe it’s the physician’s judgment that the drug may not work effectively, or may worsen the patient’s condition given their other medical problems and drug regimens? Should drug companies be trying to make these physicians — who, like most of us, don’t want to disappoint those paying them — cave?

Or maybe Big Pharma is just trying to sell something that’s kind of absurd on its face. RLS? Restless Leg Syndrome? Widely advertised, there now are at least 12 prescription drugs to treat what, at least to me, doesn’t seem like much of an illness. What about exercise? Less caffeine? A hot shower before bedtime? A brief massage? Sex? A relaxing, 250 mgs. of a Tylenol generic once in a while? Not satisfied with just manufacturing manipulative extensions of their patents, Big Pharma seems to be manufacturing illnesses too. What next? Breath-Away for those suffering from breathing too often? MatchRx for those addicted to checking their match.com accounts for new entreaties? Drugs for those who interrupt too much? Make inappropriate jokes? Aren’t good listeners? Can’t come up with good pick-up lines?